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A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
Published on: January 11, 2020
Valacyclovir Treatment in Mild Cognitive Impairment: The VALMCI Randomized Clinical Trial
Davangere P Devanand1,2, Edward D Huey3, Min Qian4
1Department of Psychiatry, New York State Psychiatric Institute.
Alzheimer Disease and Associated Disorders
|May 29, 2026
Summary
This study found that valacyclovir did not significantly reduce amyloid PET scans or improve cognitive function in individuals with mild cognitive impairment (MCI) and herpes simplex virus (HSV) positivity.
Area of Science:
- Neurology
- Virology
- Gerontology
Background:
- Emerging evidence links herpes simplex viruses (HSV) to Alzheimer disease (AD) etiology.
- Neuroscience, epidemiology, and EHR studies support a potential role for HSV in AD pathogenesis.
Purpose of the Study:
- To evaluate the efficacy of valacyclovir in treating mild cognitive impairment (MCI) in patients with HSV seropositivity and amyloid positivity.
- To assess the impact of valacyclovir on amyloid-beta (Aβ) deposition and cognitive decline.
Main Methods:
- A 12-month, randomized, double-blind, placebo-controlled pilot trial (VALMCI study) involving participants with MCI.
- Participants were seropositive for HSV1 or HSV2 and had positive 18F-florbetapir PET scans.
- Valacyclovir (4 g/day) efficacy and side effects were compared to placebo.
Main Results:
- No significant difference in 18F-florbetapir PET mean SUVR (amyloid burden) between valacyclovir and placebo groups.
- Secondary outcomes, including PACC composite z-score and ADCS-ADL-PI score, also showed no significant improvements.
- 84% of participants completed the trial, indicating good tolerability.
Conclusions:
- Valacyclovir treatment did not demonstrate efficacy in reducing amyloid burden or improving cognitive/functional outcomes in MCI patients with HSV seropositivity and amyloid positivity.
- These findings do not support the use of valacyclovir for this specific patient population.
- Further research may be needed to explore antiviral therapies in Alzheimer's disease.
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